One of the most common occurrences in EMS is a patient refusal, but the process and risks are very poorly understood. While there may be less risk involved than previously thought, EMS providers often have a poor understanding of exactly how to obtain a valid refusal. This lecture will review the concepts of what makes a person into a “patient”, how to assess decision-making capacity, how to obtain informed consent, and how to document these essential elements. We will use real-world scenarios to illustrate the proper steps and elements necessary to obtain a refusal.

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